3D腹腔镜下CME治疗对右半结肠癌患者血清MACC1、CEA、CA199水平的影响

Effect of 3D Laparoscopic CME on Serum Levels of MACC1,CEA and CA199 in Patients with Right Colon Cancer

目的:探讨3D腹腔镜下全结肠系膜切除术(CME)治疗右半结肠癌的效果及对患者血清结肠癌转移相关基因1(MACC1)、癌胚抗原(CEA)、糖类抗原199(CA199)水平的影响。方法:选取2019年3月-2020年3月佳木斯市肛肠医院收治的82例右半结肠癌患者,采用随机数字表法分为对照组和观察组,各41例。对照组给予传统开腹CME治疗,观察组给予3D腹腔镜下CME治疗。比较两组围术期情况,血清MACC1、CEA、CA199水平,术后并发症及12个月内局部复发情况。结果:两组手术时间、淋巴结清扫数目比较,差异均无统计学意义(P>0.05);观察组术中出血量、术后肛门排气时间、开始进食时间、住院时间均少于对照组(P<0.05);两组术后1周血清MACC1、CEA、CA199水平均下降,且观察组均低于对照组(P<0.05);观察组术后并发症发生率7.32%低于对照组26.83%(P<0.05);两组术后6、9个月的局部复发率比较,差异均无统计学意义(P>0.05);观察组术后12个月的局部复发率2.44%低于对照组19.51%(P<0.05)。结论:3D腹腔镜下CME治疗右半结肠癌可减轻患者手术创伤,减少术后并发症,降低血清MACC1、CEA、CA199水平,减少肿瘤负荷,降低术后局部复发风险。

Objective:To investigate the effect of 3D laparoscopic complete mesocolic excision(CME)in the treatment of right colon cancer and its effect on serum metastasis-associated in colon cancer 1(MACC1),carcinoembryonic antigen(CEA),and carbohydrate antigen 199(CA199)levels.Method:A total of 82 patients with right colon cancer treated in Jiamusi Anorectal Hospital from March 2019 to March 2020 were selected,they were divided into control group and observation group by random number table method,with 41 cases in each group.The control group was given traditional open CME treatment,and the observation group was given 3D laparoscopic CME treatment.The perioperative conditions,serum MACC1,CEA,CA199 levels,postoperative complications and local recurrence within 12 months were compared.Result:There were no statistically significant differences in the operation time and the number of lymph node dissection between the two groups(P>0.05);the intraoperative blood loss,postoperative anal exhaust time,starting time of eating,and hospital stay in the observation group were less than those in the control group(P<0.05);one week after operation,the serum levels of MACC1,CEA,and CA199 in the two groups decreased,and those in the observation group were lower than those of the control group(P<0.05);the postoperative complication rate of the observation group was 7.32%,lower than 26.83%of the control group(P<0.05);there were no significant differences in the local recurrence rate of the two groups at 6 months and 9 months after surgery(P>0.05);the local recurrence rate of the observation group at 12 months after surgery was 2.44%,lower than 19.51%of the control group(P<0.05).Conclusion:3D laparoscopic CME treatment of right-sided colon cancer can reduce surgical trauma,reduce postoperative complications,reduce serum MACC1,CEA,CA199 levels,reduce tumor burden,and reduce the risk of local recurrence after surgery.